Termite Inspection Request Form

Please fill in all *required fields.

Agent Information

* Requested By:
* E-mail Address:
* Phone #:
Fax #:
* Company Name:
Company Address:
City:
Zip Code:
Representing:
Preferred Inspection Date:

Property Information

* Property Address:
Unit/Apt#:
* City:
* Zip Code:
Type of Dwelling:
Number of Bedrooms:
 Bathrooms:
Total Square Footage:
Inspect Out Building:
* TMK:
* Seller Name:
Property Vacant:
Lockbox Combination:
Buyer Name:
Tenant Name :
Tenant Phone #:
Date of Last
Termite Treatment:
Treatment by Whom:
Directions to Property:

Escrow Information

* Escrow Company:
Escrow Officer:
Escrow Address:
City:
Zip Code:
* Escrow E-mail:
* Escrow Phone #:
* Escrow Fax #:
* Escrow Number:
* Closing Date:

Billing Information

If the escrow transaction is cancelled, funds are not withheld, or transaction falls through, the party listed below is hereby responsible for the payment in full for the requested TIR .
* Bill to Name (Party other than Escrow):
* Address:
* Phone #:
   
Additional Comments:
By clicking "Submit Request" you are acknowledging that you understand the terms of this agreement.
 

 

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